All About Insulin
Insulin is a hormone produced by the beta cells of islets of Langerhans scattered throughout the pancreas. The insulin so produced, when released into the bloodstream, travels throughout the body playing a major role in metabolism of carbohydrates, fats and proteins. Insulin also regulates the growth of body cells. Insulin Resistance (IR) is a state in which the cells of the body become defiant or resistant to the effects or functions of insulin and do not respond accordingly. So this necessitates administration of
insulin externally to the patient. However, the resistance can be offered to both the body’s own insulin (the endogenous insulin) as well as the insulin injected into the body (the exogenous insulin).
- Genetic reasons
- Metabolic Syndrome which is a group of metabolic risk factors or disease processes in a single individual causing IR. This includes high insulin levels, obesity, abnormal cholesterol levels and high blood pressure or hypertension.
- Certain medications and steroids
- Illness or an infection
Association between insulin resistance and diabetes
Insulin resistance leads or precedes the development of Type 2 or adult onset diabetes, which happens at a relatively older age. Studies point that insulin resistance develops along the way at some point in persons with Type 2 diabetes, even with the controlled and normal blood glucose levels.
Insulin by binding to the receptors on cell surfaces, enables the muscle and fat cells of the body to utilize glucose and thus aids in controlling the blood sugar or glucose levels. However, in case of insulin resistance, the muscles or cells do not adhere to this relationship and the pancreas understanding that muscles or cells are not functioning due to a shortage of insulin, keeps on producing and releasing more insulin. This results in an increased level of insulin in the blood. Till the time, pancreas is able to conquer the resistance, blood glucose levels stay normal.
However, if the pancreas is unable to meet the mounting demand, blood glucose levels begin to rise. A time comes, when
both the fasting and non-fasting the glucose levels are high. This is the stage when Type 2 diabetes manifests itself.
Other health conditions linked with insulin resistance
Apart from the metabolic syndrome, obesity (especially present in the abdominal area), increased cholesterol levels, and high blood pressure, following are the other medical conditions connected to insulin resistance:
Type 2 Diabetes
As said above, insulin resistance often precedes Type 2 diabetes and can ultimately result in the development of Type 2 diabetes.
Arteriosclerosis or atherosclerosis is progressive thickening and hardening of the walls of medium-sized and large arteries. Diabetes in addition to high levels of cholesterol, a high blood pressure, and a host of other reasons, is the leading cause of arteriosclerosis. It is to be mentioned that arteriosclerosis results in peripheral vascular disease, coronary artery disease and thus angina and heart attack.
Fatty liver which occurs due to accumulation of fat in the liver is a direct expression of the inefficient lipid or fat level control because of the insulin resistance. It is to be mentioned that fatty liver leads to liver cirrhosis.
Skin lesions medically known as acanthosis nigricans include darkening and thickening of the skin in the folds of neckline and axilla. Skin tags which often have a stalk, appear more frequently along with skin lesions in persons with insulin resistance.
Reproductive aberrations in women
Reproductive problems or aberrations are associated with insulin resistance in women. These include problems related to ovulation, irregular periods, early menopause and infertility. In addition to this, studies point that the risks of development of polycystic ovary and hyperandrogenism (high male hormone levels in females) are also associated with insulin resistance.
Who all are at risk of Insulin Resistance?
People who are overweight with a Body Mass Index (BMI) of more than 25, have a family history of Type 2 diabetes,
developed gestational diabetes, if you are a male with a waist of more than 40 inches or a female with a waist more
than 35 inches or have any of the above mentioned health conditions.
How can Insulin Resistance be managed?
Insulin resistance can be managed by making lifestyle changes and increasing the sensitivity of cells (by decreasing the resistance) to insulin. The lifestyle changes include a reduction in carbohydrate (broken down into sugars) intake. Certain carbohydrates metabolised faster are those having a high glycemic index and these are the ones which increase the blood glucose level more quickly and thus necessitate the secretion of more insulin to control the blood glucose levels. Carbohydrates with a high glycemic index include unrefined sugars, white breads etc. On the other hand, carbohydrates with low glycemic index include high fibre foods like brown rice and whole grain breads and green and coloured vegetables etc.
While genetic factors contribute a lot to insulin resistance, but the same can be managed with diet, exercise, weight loss, and medication, all of which result in perking up the sensitivity of cells to insulin.